Update on the roles of distal airways in asthma=

被引：50

作者：

Burgel, P-R. ^{[1
]}

de Blic, J. ^{[2
]}

Chanez, P. ^{[3
]}

Delacourt, C. ^{[4
]}

Devillier, P. ^{[5
]}

Didier, A. ^{[6
]}

Dubus, J-C. ^{[7
]}

Frachon, I. ^{[8
]}

Garcia, G. ^{[9
]}

Humbert, M. ^{[9
]}

Laurent, F. ^{[10
]}

Louis, R. ^{[11
]}

Magnan, A. ^{[12
]}

Mahut, B. ^{[2
]}

Perez, T. ^{[13
]}

Roche, N. ^{[14
]}

Tillie-Leblond, I. ^{[13
]}

de lara, M. Tunon ^{[10
]}

Dusser, D. ^{[1
]}

机构：

[1] Univ Paris 05, Hop Cochin, AP HP, Paris, France

[2] Univ Paris 05, Hop Necker Enfants Malad, AP HP, Paris, France

[3] Univ Mediterranee, Hop Ste Marguerite, AP HM, INSERM UMR 6020, Marseille, France

[4] CHI Creteil, Creteil, France

[5] Univ Versailles Saint Quentin, Hop Foch, UPRES EA 220, Suresnes, France

[6] Univ Toulouse, Hop Larrey, Toulouse, France

[7] Hop La Timone, Marseille, France

[8] CHU Cavale Blanche, Brest, France

[9] Hop Antoine Beclere, AP HP, Clamart, France

[10] Univ Victor Segalen Bordeaux 2, CHU Bordeaux, Inserm U 855, Bordeaux, France

[11] CHU ND Bruyeres, CHU Liege, Chenee, Belgium

[12] CHRU Nantes, Hop G & Laennec, Inserm U 533, Nantes, France

[13] CHRU Lille, Hop Albert Calmette, Lille, France

[14] Univ Paris 05, Hop Hotel Dieu, AP HP, Paris, France

来源：

EUROPEAN RESPIRATORY REVIEW | 2009年 / 18卷 / 112期

关键词：

Airway inflammation; airway remodelling; alveoli; asthma; bronchioles; distal airway;

D O I：

10.1183/09059180.00001109

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

The present review is the summary of an expert workshop that took place in Vence (France) in 2007 on the role of distal airways in asthma. The evidence showing inflammation and remodelling in distal airways, and their possible involvement in asthma control and natural history, was reviewed. The usefulness and limitations of various techniques used for assessing distal airways were also evaluated, including pulmonary function tests and imaging. Finally, the available data studying the benefit of treatment better targeting distal airways in asthma was examined. It was concluded that both proximal and distal airways were involved in asthma and that distal airways were the major determinant of airflow obstruction. Inflammation in distal airways appeared more intense in severe and uncontrolled asthma. Distal airways were poorly attained by conventional aerosol of asthma medications owing to their granulometry, being composed of 3- 5 mm particles. Both proximal and distal airways might be targeted either by delivering medications systemically or by aerosol of extra-fine particles. Extra-fine aerosols of long- acting b-agonists, inhaled corticosteroids or inhaled corticosteroid/long-acting b-agonist combinations have been shown in short-term studies to be not inferior to non-extra-fine aerosols of comparators. However, available studies have not yet demonstrated that extra- fine inhaled medications offer increased benefit compared with usual aerosols in asthmatic patients.

引用

页码：80 / 95

页数：16

共 162 条

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